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Impact of Occupational Footwear and Workload on Lower Extremity Muscular Exertion

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Impact of Occupational Footwear and Workload on Lower Extremity Muscular Exertion Original Research Impact of Occupational Footwear and Workload on Lower Extremity Muscular Exertion ALANA J. TURNER*1, JONATHAN C. SWAIN*1, KATHERINE L. McWHIRTER*1, ADAM C. KNIGHT‡1, DANIEL W. CARRUTH‡2 and HARISH CHANDER‡1 1Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, Starkville, MS, USA; 2Human Performance Laboratory, Center for Advanced Vehicular Systems, Mississippi State University, Starkville, MS, USA *Denotes undergraduate student author, ‡Denotes professional author ABSTRACT International Journal of Exercise Science 11(1): 331-341, 2018. Footwear worn and workload performed can influence muscular exertion, which is critical in occupational environments. The purpose of the study was to assess the impact of two occupational footwear, steel-toed (SWB) and tactical (TWB) work boots, on muscular exertion when exposed to a physical workload. Eighteen healthy male participants (age: 21.27 ± 1.7 years; height: 177.67 ± 6.0 cm; mass: 87.95 ± 13.8 kg) were tested for maximal voluntary isometric contraction (MVIC) using electromyography (EMG) and pressure pain threshold (PPT) using an algometer for four lower extremity muscles prior to (pre-test) and two times after a physical treadmill workload (post-test 1 & post-test 2). Additionally, heart rate (HR), ratings of perceived exertion (RPE) at the end of the workload, and recovery were recorded along with the time spent on treadmill (TT). Results from the study revealed that PPT was significantly lowered in ankle dorsiflexors immediately following the workload and EMG mean and peak muscle activity were significantly lowered in post-test 2 session in knee extensors. No significant differences were found between footwear types in all measures. The findings could be attributed to the acute muscle soreness as a result of muscular exertion from the workload. The footwear design and mass did not impact PPT, MVIC, HR, RPE, and TT with the workload administered in the study. KEY WORDS: Muscular exertion, pressure pain threshold, occupational footwear INTRODUCTION Many physical hazards and stresses exist among occupational workers, which include lifting and carrying heavy loads, standing and walking for prolonged durations of time and usage of personal protective equipment (PPE). The primary event or exposure leading to injury and illness in occupational environments is overexertion with 376,190 cases accounting for 33 percent of all cases reported (3). Such hazards and stresses can be directly implicated to a number of health problems that have musculoskeletal, neurological and/or cardiovascular origins. A common health issue, muscular exertion and fatigue, can be defined as a gradual decrease in the force capacity of muscle and develops soon after the beginning of the sustained Int J Exerc Sci 11(1): 331-341, 2018 activity (8). This reduction in the muscular force has been implicated to a decrease in working capability and results in an internal perturbation to the motor control system thereby inducing impairment in motor coordination (19). Disturbances to the human motor control systems can result in an abated ability for efficient completions of motor tasks. The ability to perform tasks accompanied by fatigue is a hazardous condition for workers. Subjective measures of muscular exertion have been quantified using ratings of discomfort, such as visual analog scale (7) and ratings of perceived exertion (RPE) (23), and with more reliable subjective ratings, such as pressure pain threshold (PPT) using pressure pain algometry (6, 9). Objective measures of muscular exertion and fatigue have also been quantified by measuring a reduction in force production of the muscle and by identifying change in muscle activity patterns using electromyography (EMG) (8). Moreover, both these subjective and objective measures are performed before and after a period of sustained activity/workload and muscular exertion in order to identify the impact of such workload on muscular exertion (8). In addition to intrinsic factors of the human body such as age, presence or absence of health complications, level of fitness, attentional demands, work experience, and the way a particular task is performed; many extrinsic factors (factors that are external to the human body) such as load carriage, working surface or terrain, type of task and personal protective equipment (PPE) that includes occupational footwear can influence muscular exertion and fatigue. With most of the strenuous, physically demanding occupational tasks being performed with feet on the ground, the footwear worn becomes a vital extrinsic factor in the contribution to muscular fatigue and overall human performance in occupational tasks. Footwear serves as the interface between the human foot and the ground and plays an extremely crucial role during both static and dynamic tasks. Inappropriate or incorrectly designed footwear, especially with additional physical workload and muscular exertion to the lower extremities, have been shown to have detrimental effects to human performance (4, 5). Earlier studies have shown an increase in energy expenditure and subsequently a potential faster rate of fatigue in many scenarios such as, using footwear compared to barefoot (13), using footwear that are heavier in mass compared to lighter footwear (21) and using the same footwear with its mass being increased (15). Additionally, decreased force production and increased muscular fatigue were shown with heavier footwear (firefighter rubber boots) compared to lighter footwear (firefighter leather boots) (12). With the leading event or exposure for occupational injuries and illness being workload overexertion (3), and with footwear playing a decisive role in muscular exertion and the development of muscular fatigue, it is crucial to understand muscular fatigue that is experienced in occupational settings in order to minimize injuries and promote safety. Specifically, the impact of occupational footwear, such as steel-toed work boots and tactical work boots, in response to low intensity - long duration workload and no workload on human performance involving postural stability has been previously established (4, 5). Occupations that predominantly use these boots include the construction and manufacturing sectors, which had a total of 79,890 and 122,610 reported cases of non-fatal injuries respectively (3). However, the influence of these work boots when exposed to a high intensity - short duration workload, such as construction workers working on a roof, have not been identified, especially focusing International Journal of Exercise Science http://www.intjexersci.com 332 Int J Exerc Sci 11(1): 331-341, 2018 on muscular exertion and fatigue. Therefore, the purpose of the study was to assess the impact of two types of occupational footwear; tactical work boot (TWB) and steel-toed work boot (SWB), on subjective and objective measures of fatigue, when exposed to a simulated high intensity workload. We hypothesized that the muscular exertion quantified by PPT and EMG will be greater after the workload and in the steel-toed work boot. (a) (b) Figure 1. Occupational footwear. (a) Tactical work boot (TWB) and (b) Steel-toed work boot (SWB). METHODS Participants Eighteen healthy male participants (age: 21.27 ± 1.7 years; height: 177.67 ± 6.0 cm; mass: 87.95 ± 13.8 kg) with no self-reported history of musculoskeletal, neurological, or cardiovascular abnormalities completed the study. Participants’ physical fitness status was also above recreationally trained (>3-4 days/week with consistent aerobic and anaerobic training for the at least the last 3 months). Sample size was determined a priori from similar, previous studies in the laboratory and cross checked by using G-Power statistical software with a desired power of 0.8, a desired effect size of 0.25, and at an alpha level of 0.05. As the construction and manufacturing industries have a predominant male population and due to the availability of only male size steel-toed and tactical work boots, only a male population was recruited for the study. All procedures were approved by the University’s Institutional Review Board (IRB) for human subjects’ research [Approval: IRB 16-388]. Protocol The experimental protocol followed a pre-test - post-test repeated measures design consisting of two separate days of testing with an initial familiarization day. On the familiarization day, after obtaining informed consent, participants were exposed to a familiarization session that included testing methods of PPT using an algometer, especially the subjective feeling of discomfort during the PPT testing, and performing maximal voluntary isometric contractions of the lower extremity muscles. General anthropometric assessment and a physical activity readiness questionnaire (PAR-Q) were also obtained that included age, height, mass, shoe size, and general information about physical activity levels. After the familiarization day, participants were tested on two experimental testing days following the same protocol on each boot condition [TWB – mass: 0.5 kg and SWB – mass: 0.9 kg] (Figure 1) using a counter International Journal of Exercise Science http://www.intjexersci.com 333 Int J Exerc Sci 11(1): 331-341, 2018 balanced design to remove order effects. Each testing session began with an initial 3-5 minute warm up consisting of walks, jogs, high knees and jumping jacks. Participants were then analyzed for maximal voluntary contraction (MVIC) and pressure pain threshold (PPT) prior (pre-test) to and
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